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Catch-Up Growth Spurts in Children with Celiac Disease

Will Your Celiac Child Regain Lost Ground in Height After Diagnosis?

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Updated June 08, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Catch-Up Growth Spurts in Children with Celiac Disease
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Many children with celiac disease are shorter than their non-celiac peers — in fact, short stature can suggest that an undiagnosed child (even one with no other symptoms) suffers from the condition.

But once that child is diagnosed and begins following the gluten-free diet, can she regain some or all of that lost growth? Evidence from medical studies and real-life experiences of celiac children suggests the answer is a qualified "yes."

Celiac Disease Fairly Common in Children with Short Stature

Since children grow at dramatically different rates, it's common to see similar-aged peers with one towering over the other. Just being shorter than average isn't enough to qualify a child for short stature — a child is considered to have short stature if she is shorter than 95% to 97% of her peers.

Even then, that short stature might not be cause for concern if your child has been growing at a steady rate and seems to be headed for normal (although short-normal) adult height. It's when children "fall off the growth charts," or suddenly slow or halt their growth, that you may need to investigate a reason for the problem with your pediatrician.

Several studies have investigated how many children with short stature actually suffer from celiac disease. They have found rates of celiac from about 3% to more than 8% in children with otherwise unexplained short stature. (As a reference point, celiac disease occurs in about 1% of the overall population.)

Many of the children diagnosed as a result of these studies did not have obvious symptoms of celiac disease common in children. In fact, some study authors warned that physicians can't use gastrointestinal symptoms as an indicator, because many of the kids in these studies lacked them.

Growth Once Celiac Kids Go Gluten-Free

Many parents and kids alike hope for some catch-up growth once the child starts eating gluten-free, and anecdotal reports indicate this often occurs. In fact, one teen boy I know spurted up quickly once he went gluten-free, and now tops most of his peers.

The few studies that have been done on this subject tend to support the idea of catch-up growth, although the researchers have found that growth doesn't always catch up completely.

One study, performed in India, found that 60% of the study subjects suffered from malnutrition due to undiagnosed celiac disease. In addition, more than three-quarters of the children were shorter than 97.5% of their peers.

Over a follow-up period that averaged more than three-and-a-half years, 84% of the children recovered from that celiac-induced malnutrition, and many initially grew rapidly -- the children gained an average of 5.5 inches in height the first year. However, growth then tapered off to an average of 2.2 inches in subsequent years.

Another study, this one in Serbia, found similar results. The researchers looked at 90 children ages 6 months to seven years with "classic celiac disease," and found that the children grew more rapidly than their peers during their first one to three years on the gluten-free diet.

Catch-Up Growth Might Not Catch Up Completely

These studies indicate there is hope for a very short child, pre-teen or even young teen who is newly diagnosed with celiac disease and wants to get taller. However, another study indicates that the catch-up growth might not produce perfect results.

In that study, researchers in India looked at 50 "late-diagnosed" children who were 2 to 10 years old at the time of diagnosis.

They found that following the gluten-free diet led to an overall significant increase in one measure of "height for age" in the children over a 4-year follow-up period.

"However, the catch-up in height was incomplete, with stunting in sixteen (55.4%) of 29 children after three years and in seven (46.6%) of 15 children after four years on the gluten-free diet," they said, adding, "our results suggest that, in children with late-diagnosed celiac disease, treatment with a gluten-free diet leads to a normalization of body mass and a significant but incomplete recovery in [height-for-age scores] during four years of follow-up."

What Does This Mean For Your Child?

The results of these studies indicate it's reasonable to expect some catch-up growth, especially in the first year or two following your child's celiac disease diagnosis.

It's not clear from the research whether it matters if your child follows the diet strictly; some studies say they must do so to gain height, while others indicate that children grow regardless of whether they cheat on the diet, as long as they don't completely revert to a gluten-filled diet. (Of course, there are plenty of other reasons not to cheat on the gluten-free diet.)

There also could be other, non-celiac-related reasons if your child continues to lag behind in height even after going gluten-free. Your child may have a growth hormone deficiency or another hormonal problem, or she may simply be destined to be short as an adult. If you have concerns about your celiac child's growth, you should discuss them with your pediatrician.

Sources:

Cacciari E. et al. Short stature and celiac disease: a relationship to consider even in patients with no gastrointestinal tract symptoms. Journal of Pediatrics. 1983 Nov;103(5):708-11.

Dehghani S. et al. Celiac disease in children with short stature. Indian Journal of Pediatrics. 2008 Feb;75(2):131-3.

Patwari A. et al. Catch-up growth in children with late-diagnosed coeliac disease. British Journal of Nutrition. 2005 Sep;94(3):437-42.

Queiroz M. et al. Prevalence of celiac disease in Brazilian children of short stature. Brazilian Journal of Medical and Biological Research. 2004 Jan;37(1):55-60. Epub 2003 Dec 18.

Radlović N. et al. Effect of gluten-free diet on the growth and nutritional status of children with coeliac disease. Srp Arh Celok Lek. 2009 Nov-Dec;137(11-12):632-7.

Yachha S. et al. Effect of a gluten-free diet on growth and small-bowel histology in children with celiac disease in India. Journal of Gastroenterology and Hepatology. 2007 Aug;22(8):1300-5. Epub 2007 Jun 12.

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